Mycobacterium abscessus natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Infection with mycobacterium abscessus (M. abscessus) can lead to skin, soft tissues and bone infections, bronchopulmonary infections, and disseminated infection in non-AIDS immunocompromised patients[1] Minor infections with M. abscessus can resolve either spontaneously or following surgical debridement.[2] The majority of pulmonary M. abscessus infection are chronic and incurable. When pulmonary M. abscessus infection occurs in the absence of any predisposing conditions, the course of the disease is slowly progressive and indolent. Whereas, when the pulmonary infection is associated with underlying predisposing factors, such as gastrointestinal or pulmonary conditions, the disease is rapidly progressive and fulminant.[3]
Natural History, Complications and Prognosis
Infection with M. abscessus can lead to:
- Skin, soft tissues and bone infections
- Open wound infection
- Bronchopulmonary infection[1]
- Disseminated infection in non-AIDS immunocompromised patients[1]
- M. abscessus hand-and-foot disease[5][6]
- Other rare infections
- Vertebral osteomyelitis[7]
- Abdominal infection[8]
- Lymphadenitis[2]
Skin and Soft Tissue Infection
Minor infections with M. abscessus can resolve either spontaneously or following surgical debridement. In the absence of therapy, abscesses that occur after injection of the organism may last up to 8 to 12 months until they resolve spontaneously.[2]
M. abscessus hand-and-foot disease has been described in the pediatric population with wading and public pool exposure.[5][6] The disease is characterized by self limited tender, erythematous, pustules, papules, and abscesses in the hands and feet.[5][6]
Pulmonary Infection
M. abscessus is the most common non tuberculosis mycobacterial infection in cystic fibrosis.[9] Chronic infection with M. abscessus is associated with a decline in lung function among patients with cystic fibrosis.[10] The most commonly reported symptom is cough. Constitutional symptoms increase as the disease progresses. The only effective long-term therapy for M. abscessus was reported to be surgical resection of the localized disease.[3] Death may occur in these patients (mortality in ~14% of patients) due to respiratory failure secondary to the progressive lung disease.[3]
When pulmonary M. abscessus infection occurs in the absence of any predisposing conditions, the course of the disease is slowly progressive and indolent. Whereas, when the pulmonary infection is associated with underlying predisposing factors, such as gastrointestinal or pulmonary conditions, the disease is rapidly progressive and fulminant.[3]
The majority of pulmonary M. abscessus infection are chronic and incurable. Successful treatment is more likely if the disease is limited and if the patient undergoes surgical resection following the initial antibiotic therapy.[2]
References
- ↑ 1.0 1.1 1.2 Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B (2012). "Mycobacterium abscessus: a new antibiotic nightmare". J Antimicrob Chemother. 67 (4): 810–8. doi:10.1093/jac/dkr578. PMID 22290346.
- ↑ 2.0 2.1 2.2 2.3 Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F; et al. (2007). "An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases". Am J Respir Crit Care Med. 175 (4): 367–416. doi:10.1164/rccm.200604-571ST. PMID 17277290.
- ↑ 3.0 3.1 3.2 3.3 Griffith DE, Girard WM, Wallace RJ (1993). "Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients". Am Rev Respir Dis. 147 (5): 1271–8. doi:10.1164/ajrccm/147.5.1271. PMID 8484642.
- ↑ Hoffman PC, Fraser DW, Robicsek F, O'Bar PR, Mauney CU (1981). "Two outbreaks of sternal wound infection due to organisms of the Mycobacterium fortuitum complex". J Infect Dis. 143 (4): 533–42. PMID 7240799.
- ↑ 5.0 5.1 5.2 Dytoc MT, Honish L, Shandro C, Ting PT, Chui L, Fiorillo L; et al. (2005). "Clinical, microbiological, and epidemiological findings of an outbreak of Mycobacterium abscessus hand-and-foot disease". Diagn Microbiol Infect Dis. 53 (1): 39–45. doi:10.1016/j.diagmicrobio.2005.03.010. PMID 16054324.
- ↑ 6.0 6.1 6.2 Sinagra JL, Kanitz EE, Cerocchi C, Cota C, Fantetti O, Prignano G; et al. (2014). "Mycobacterium abscessus hand-and-foot disease in children: rare or emerging disease?". Pediatr Dermatol. 31 (3): 292–7. doi:10.1111/pde.12333. PMID 24758202.
- ↑ Garcia DC, Sandoval-Sus J, Razzaq K, Young L (2013). "Vertebral osteomyelitis caused by Mycobacterium abscessus". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-009597. PMID 23925676.
- ↑ Ding LW, Lai CC, Lee LN, Hsueh PR (2006). "Abdominal nontuberculous mycobacterial infection in a university hospital in Taiwan from 1997 to 2003". J Formos Med Assoc. 105 (5): 370–6. doi:10.1016/S0929-6646(09)60132-7. PMID 16638646.
- ↑ Sermet-Gaudelus I, Le Bourgeois M, Pierre-Audigier C, Offredo C, Guillemot D, Halley S; et al. (2003). "Mycobacterium abscessus and children with cystic fibrosis". Emerg Infect Dis. 9 (12): 1587–91. doi:10.3201/eid0912.020774. PMC 3034322. PMID 14720400.
- ↑ Esther CR, Esserman DA, Gilligan P, Kerr A, Noone PG (2010). "Chronic Mycobacterium abscessus infection and lung function decline in cystic fibrosis". J Cyst Fibros. 9 (2): 117–23. doi:10.1016/j.jcf.2009.12.001. PMC 3837580. PMID 20071249.